| Doctor Name: | BETHANY LISS NOTAFRAID |
| NPI Number: | 1477726032 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 35764 |
| Business Practice Address: | 456 Gros Ventre Avenue Harlem, MT - 595260456 |
| Business Phone Number: | 4063533235 |
| Business Fax Number: | 4063533283 |
| Mailing Address: | Rr 1 Box 67, HARLEM |
| State: | MT |
| Postal Code: | 595269705 |
| Phone Number: | 4063533235 |
| Fax Number: | 4063533283 |
| NPI Enumeration Date: | 04/03/2008 |
| NPI Last Update Date: | 04/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 35764 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |